| Doctor Name: | MARK STEVEN PETERSON |
| NPI Number: | 1003980053 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | MD16135 |
| Business Practice Address: | 1535 Liberty St Se Salem, OR - 973024345 |
| Business Phone Number: | 5033718346 |
| Business Fax Number: | 5036718334 |
| Mailing Address: | Po Box 824, SALEM |
| State: | OR |
| Postal Code: | 973080824 |
| Phone Number: | 5033718346 |
| Fax Number: | 5033718334 |
| NPI Enumeration Date: | 11/20/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2086S0129X |
| License Number: | MD16135 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Surgery |
| Taxonomy Specialization: | Vascular Surgery |
| Taxonomy Definition: | A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |